PMID- 32038477
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200214
IS  - 1664-2392 (Print)
IS  - 1664-2392 (Electronic)
IS  - 1664-2392 (Linking)
VI  - 10
DP  - 2019
TI  - A Short-Term Ketogenic Diet Impairs Markers of Bone Health in Response to 
      Exercise.
PG  - 880
LID - 10.3389/fendo.2019.00880 [doi]
LID - 880
AB  - Objectives: To investigate diet-exercise interactions related to bone markers in 
      elite endurance athletes after a 3.5-week ketogenic low-carbohydrate, high-fat 
      (LCHF) diet and subsequent restoration of carbohydrate (CHO) feeding. Methods: 
      World-class race walkers (25 male, 5 female) completed 3.5-weeks of 
      energy-matched (220 kJ.kg.d(-1)) high CHO (HCHO; 8.6 g.kg.d(-1) CHO, 2.1 
      g.kg.d(-1) protein, 1.2 g.kg.d(-1) fat) or LCHF (0.5 g.kg.d(-1) CHO, 2.1 
      g.kg.d(-1) protein, 75-80% of energy from fat) diet followed by acute CHO 
      restoration. Serum markers of bone breakdown (cross-linked C-terminal telopeptide 
      of type I collagen, CTX), formation (procollagen 1 N-terminal propeptide, P1NP) 
      and metabolism (osteocalcin, OC) were assessed at rest (fasting and 2 h post 
      meal) and after exercise (0 and 3 h) at Baseline, after the 3.5-week intervention 
      (Adaptation) and after acute CHO feeding (Restoration). Results: After 
      Adaptation, LCHF increased fasting CTX concentrations above Baseline (p = 0.007, 
      Cohen's d = 0.69), while P1NP (p < 0.001, d = 0.99) and OC (p < 0.001, d = 1.39) 
      levels decreased. Post-exercise, LCHF increased CTX concentrations above Baseline 
      (p = 0.001, d = 1.67) and above HCHO (p < 0.001, d = 0.62), while P1NP (p < 
      0.001, d = 0.85) and OC concentrations decreased (p < 0.001, d = 0.99) during 
      exercise. Exercise-related area under curve (AUC) for CTX was increased by LCHF 
      after Adaptation (p = 0.001, d = 1.52), with decreases in P1NP (p < 0.001, d = 
      1.27) and OC (p < 0.001, d = 2.0). CHO restoration recovered post-exercise CTX 
      and CTX exercise-related AUC, while concentrations and exercise-related AUC for 
      P1NP and OC remained suppressed for LCHF (p = 1.000 compared to Adaptation). 
      Conclusion: Markers of bone modeling/remodeling were impaired after short-term 
      LCHF diet, and only a marker of resorption recovered after acute CHO restoration. 
      Long-term studies of the effects of LCHF on bone health are warranted.
CI  - Copyright (c) 2020 Heikura, Burke, Hawley, Ross, Garvican-Lewis, Sharma, McKay, 
      Leckey, Welvaert, McCall and Ackerman.
FAU - Heikura, Ida A
AU  - Heikura IA
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Burke, Louise M
AU  - Burke LM
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Hawley, John A
AU  - Hawley JA
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Ross, Megan L
AU  - Ross ML
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Garvican-Lewis, Laura
AU  - Garvican-Lewis L
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Sharma, Avish P
AU  - Sharma AP
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - Griffith Sports Physiology and Performance, School of Allied Health Sciences, 
      Griffith University, Gold Coast, QLD, Australia.
FAU - McKay, Alannah K A
AU  - McKay AKA
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - School of Human Sciences (Exercise and Sport Science), The University of Western 
      Australia, Crawley, WA, Australia.
FAU - Leckey, Jill J
AU  - Leckey JJ
AD  - Exercise and Nutrition Research Program, Mary MacKillop Institute for Health 
      Research, Australian Catholic University, Melbourne, VIC, Australia.
FAU - Welvaert, Marijke
AU  - Welvaert M
AD  - Australian Institute of Sport, Canberra, ACT, Australia.
AD  - University of Canberra Research Institute for Sport and Exercise, Canberra, ACT, 
      Australia.
AD  - Statistical Consulting Unit, Australian National University, Canberra, ACT, 
      Australia.
FAU - McCall, Lauren
AU  - McCall L
AD  - Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United 
      States.
FAU - Ackerman, Kathryn E
AU  - Ackerman KE
AD  - Division of Sports Medicine, Boston Children's Hospital, Boston, MA, United 
      States.
AD  - Neuroendocrine Unit, Massachusetts General Hospital and Harvard Medical School, 
      Boston, MA, United States.
LA  - eng
PT  - Journal Article
DEP - 20200121
PL  - Switzerland
TA  - Front Endocrinol (Lausanne)
JT  - Frontiers in endocrinology
JID - 101555782
PMC - PMC6985427
OTO - NOTNLM
OT  - bone health
OT  - endurance athletes
OT  - exercise
OT  - ketogenic diet
OT  - nutrition
EDAT- 2020/02/11 06:00
MHDA- 2020/02/11 06:01
PMCR- 2019/01/01
CRDT- 2020/02/11 06:00
PHST- 2019/09/04 00:00 [received]
PHST- 2019/12/02 00:00 [accepted]
PHST- 2020/02/11 06:00 [entrez]
PHST- 2020/02/11 06:00 [pubmed]
PHST- 2020/02/11 06:01 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
AID - 10.3389/fendo.2019.00880 [doi]
PST - epublish
SO  - Front Endocrinol (Lausanne). 2020 Jan 21;10:880. doi: 10.3389/fendo.2019.00880. 
      eCollection 2019.